iPads Out, “Zero Clients” In As EMR Front Ends At Seattle Children’s

Posted on December 14, 2011 I Written By

Anne Zieger is veteran healthcare branding and communications expert with more than 25 years of industry experience. and her commentaries have appeared in dozens of international business publications, including Forbes, Business Week and Information Week. She has also worked extensively healthcare and health IT organizations, including several Fortune 500 companies. She can be reached at @ziegerhealth or www.ziegerhealthcare.com.

It’s a good thing the IT execs at Seattle Children’s Hospital did a thorough test before they rolled out an iPad front end to their Cerner EMR.  As it turns, out going with the iPad might have been a disaster. In fact, the whole incident begs the question as to whether the iPad works as a browser-based EMR client at all.

As readers know, iPads are very popular with doctors, and many hospitals are considering using iPads as a front door to their EMR system. But in many cases, doctors are finding that the iPad isn’t a great host for desktop-sized applications.

That’s certainly what happened at Seattle Children’s, which trialed iPads with its doctors earlier this fall.  In theory, the hospital was a great fit, as it was in the process of a Citrix virtual desktop infrastructure rollout, an approach which made apps available to any Web-connected device running a browser.

But doctors didn’t like using the iPad to access their EMR. Every doctor who was asked to test out the iPad returned it, saying that it was far too awkward to use, according to CIO magazine. “The EMR apps are unwieldy on the iPad,” CTO Wes Wright told the publication.

And when you think about it, the doctors’ reaction is no surprise. After all, they were using Safari on a small tablet to access apps designed for a 21 inch monitor, an awkward experience at best, notes CIO’s Neil Versel.

So, rather than use iPads as endpoints, the hospital has rolled out 2,600 “zero client” devices from Wyze, mounting the devices on COWs sitting by the patient bedside. (It’s also beta-testing Cisco’s Cius tablets, according to Computerworld.) Seattle Children’s should save $400,000 a year by replacing 70 watt desktops with 7 watt zero clients, Wright projects.

The hospital is consolidating access to the apps on Cisco’s Unified Computing System, and virtualizing access to Cerner using Citrix XenDesktop.

Given the problems doctors face in using the iPad-plus-browser to access EMRs, I do have to wonder so few vendors seem to have developed native iPad applications yet — even giants like Cerner with huge development budgets.

Though I have no proof of this, I get the distinct feeling many vendors would prefer to wait out the current iPad development cycle and see what Meaningful Use brings next before they jump in.  If so, are they stifling the iPad market or just being smart?  What do you think?